Transjejunal Ercp (Tj-Ercp) In Patients With Roux-En-Y Hepatico-Jejunostomy (Ryhj) Through Internal Eus-Guided Bypass Anastomoses With Lumen-Apposing Metal Stents (Lams)

Percutaneous transjejunal access is used for ERCP in patients with bilio-enteric anastomoses and postoperative upper GI tract anatomy who have limitations for enteroscopy-assisted ERCP or percutaneous transhepatic biliary drainage. A number of percutaneous procedures can be internalized by EUS-guided approaches, decreasing patient inconvenience. Novel LAMS allow reliable GI anastomoses in experimental and clinical settings. We hypothesized that EUS-guided transjejunal LAMS anastomoses could be used to facilitate ERCP in select RYHJ patients.